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Remote Ischemic Conditioning Associated With Better Neurologic Function After Stroke
Remote ischemic conditioning in adults with acute moderate ischemic stroke significantly increased the likelihood of excellent neurologic function at 90 days compared with usual care, according to a study published in JAMA.
Remote ischemic conditioning consists of repeated occlusion/release cycles on bilateral upper limb arteries. While studies have suggested a neuroprotective effect of the intervention, a lack of robust evidence prompted investigators to conduct a multicenter, open-label trial.
The study spanned 55 hospitals in China. Between December 26, 2018, through January 19, 2021, 1893 patients with acute moderate ischemic stroke were randomized to either usual care or usual care plus remote ischemic conditioning for 10 to 14 days. The intervention used a pneumatic electronic device and consisted of 5 cycles of cuff inflation for 5 minutes, and deflation for 5 minutes, to the bilateral upper limbs to 200 mm Hg, researchers explained.
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Among patients randomised to adjunctive remote ischemic conditioning, 67.4% achieved excellent neurologic function at 90 days, compared with 62.0% who received guideline-based usual care alone, according to the study. Excellent neurologic function was defined as a modified Rankin Scale score of 0 to 1.
Adverse events occurred in 6.8% of patients who underwent remote ischemic conditioning and 5.6% of patients who received only usual care. Adverse events in the remote ischemic conditioning group mostly involved redness, swelling, or skin petechiae on the arms, according to study coverage in MedPage Today.
Due to the novelty of the therapy, “[T]hese findings require replication in another trial before concluding efficacy for this intervention,” researchers advised.
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